Glucose-6-phosphate dehydrogenase (G6PD) deficiency is among the most common enzyme disorders affecting red blood cells. It often remains unnoticed until the individual is exposed to oxidative stress, which can trigger rapid hemolysis. Methemoglobinemia develops when hemoglobin becomes oxidized into a form that cannot efficiently transport oxygen. This leads to impaired oxygen delivery to tissues and cyanosis that does not improve despite supplemental oxygen. Although uncommon, methemoglobinemia can develop as a serious complication during episodes of severe oxidative stress. We describe the case of an 11-month-old boy who developed acute hemolysis together with methemoglobinemia shortly after his first exposure to peanuts.
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